Medicaid is the main payer for more than half of the 20,226 people in Minnesota nursing homes. With his July 3, 2025 vote for the One Big Beautiful Bill Act, Brad Finstad helped pass a law that reaches both that money and the staff who care for them: the law keeps Washington from enforcing the 2024 staffing standard for nursing homes, with the ban lasting until September 30, 2034, and its limits on provider taxes and state-directed payments drain $340 billion of federal Medicaid money in a decade from nursing homes, hospitals and other providers, KFF calculates.
Older Minnesotans still living at home are exposed too. The House bill Finstad's yes rescued in May 2025 put on hold rules that let low-income seniors more easily get Medicare premiums paid; three months before, in February 2025, his deciding budget vote fixed an $880 billion savings target for the Energy and Commerce Committee, which oversees Medicaid, and the Medicaid cuts that followed bring pressure that can fall on optional services such as home care.
Brad Finstad's Votes on Nursing Homes, Home Care and Help for Low-Income Seniors
- Nursing-Home Residents See the Federal Staffing Rule Shelved and Billions in Medicaid Support Cut After Finstad's July 2025 Vote for the Final Law. On July 3, 2025, Brad Finstad added his name to the 218-member majority that gave the One Big Beautiful Bill Act final approval over 214 opponents. Its Medicaid cuts, KFF wrote, "could affect the 22 million people ages 50 and older with coverage under the Medicaid program." The law also bars Washington from enforcing the staffing rule adopted for nursing homes in 2024, a ban that runs through September 30, 2034, locking in, as KFF puts it, a federal court ruling against central parts of that rule. Keeping the staffing rule on ice saves federal Medicaid $23 billion over ten years by KFF's count, money that would have paid for the caregivers the rule required. Separately, the provider-tax and state-directed-payment limits cut $340 billion in federal funds over the same ten years from the nursing homes, hospitals and other providers that lean on that money.
- Low-Income Seniors Face Higher Medicare Bills After Finstad's Deciding Vote on the House Bill in May 2025. Exactly 215 votes, Finstad's among them, carried H.R. 1's House draft on May 22, 2025, against 214, with one member voting present. It paused most of two rules, a pause the final law kept, that help low-income seniors get enrolled in the programs that pick up their Medicare premiums and cost sharing. In the final law, by KFF's account, the pause on the two rules is "collectively estimated to reduce federal Medicaid spending by $122 billion," and a senior who loses the help can owe Medicare premiums of $185 a month, close to 20% of income.
- Older People Who Depend on Home Care Face Medicaid Cuts Rooted in the February 2025 Budget Plan Finstad Voted For. Two votes was the whole margin for H.Con.Res. 14 on February 25, 2025, adopted 217 to 215 with Finstad in favor; had he reversed, the result would have been a tie, which fails. The resolution gave the Energy and Commerce Committee a floor of savings: "reduce the deficit by not less than $880,000,000,000". Most home care is the kind states are not required to cover, and the Bipartisan Policy Center warns that this optional status leaves it "more vulnerable to reductions during periods of state or federal budget constraints," which puts at risk the aides who help older people bathe, dress and stay out of institutions.
What Brad Finstad's Votes Mean for Older Minnesotans in Nursing Homes and at Home
- Medicaid pays first for 53% of the 20,226 Minnesotans in nursing homes, and the law cuts its funding. Minnesota's certified nursing facilities housed 20,226 residents in KFF's latest count, and KFF data list Medicaid as the primary payer for 53% of them, which means the $19.1 billion the law takes from federal Medicaid funding for Minnesota lands on the program covering a majority of nursing-home beds, meals and aides in the state.
- Older Minnesotans are among the 140,000 the state expects to lose coverage. Minnesota health officials expect about 140,000 Minnesotans to lose their coverage under the law, MPR News reported, among them adults in their 50s and early 60s who will have to document work hours to keep Medical Assistance starting January 1, 2027.
Frequently Asked Questions About Brad Finstad on Elder care
What is Brad Finstad's record on elder care under Trump?
Brad Finstad voted for the One Big Beautiful Bill Act, which keeps the federal nursing-home staffing standard unenforced until 2034 and, through provider-tax and state-directed-payment limits that support nursing homes and hospitals, cuts $340 billion from federal Medicaid. His May 2025 House vote, without which the bill would have failed, was for a freeze on rules that help poorer seniors pay Medicare premiums, a freeze the final law kept. His deciding February 2025 budget vote set a savings target of at least $880 billion for Energy and Commerce, the House committee that writes Medicaid law.
Who in southern Minnesota's 1st District relies on the Medicaid care Brad Finstad voted to cut?
Brad Finstad's votes reach 11,400 seniors and 12,100 people with disabilities who were on Medicaid in Minnesota's 1st District in 2025, KFF counts. Medicaid pays for "almost 70% of all home care spending in the U.S.," KFF notes, so the cuts bear on the in-home aides many older people in the district rely on to avoid moving into a nursing home.
Did Brad Finstad vote to stop federal staffing minimums for Minnesota nursing homes?
Yes. Brad Finstad cast a yes on July 3, 2025 for the measure that bars enforcement of the 2024 federal nursing-home staffing rule until September 30, 2034. The Consumer Voice, a national advocate for people in long-term care, put the stakes this way: "The minimum staffing rule was estimated to save 13,000 lives annually."
Last updated: 2026-10-27